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Impact of COPD on Inhalation Injury Outcomes
Christopher J. Fedor, MS; Jose A. Arellano, MD; Mare G. Kaulakis, BS; Hilary Y. Liu, BS; Garth A. Elias, MD; Alain C. Corcos, MD; Matthew P. Siedsma, MD; Jenny A. Ziembicki, MD; Francesco M. Egro, MD, MSc, MRCS
University of Pittsburgh, School of Medicine
2025-01-02
Presenter: Christopher J. Fedor
Affidavit:
I agree.
Director Name: Vu Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
PURPOSE:
Chronic obstructive pulmonary disease (COPD) is marked by airway obstruction, leading to air trapping and shortness of breath, which may hinder lung function essential for fighting infections. Inhalation injuries can cause significant airway damage, complicating healing for those with COPD. Understanding these outcomes is crucial for patients who may require reconstructive procedures. This study examines the impact of COPD comorbidity on clinical outcomes in inhalation injury patients.
METHODS:
We performed a 12-year retrospective analysis of burn patients from a tertiary care ABA-certified burn center. Inhalation injuries were confirmed via fiberoptic bronchoscopy, excluding flash burns from smoking on home oxygen. COPD severity was ranked per the Global Initiative for Obstructive Lung Disease criteria. Outcome variables included total body surface area (TBSA) burns, carboxyhemoglobin (COHb) at presentation, complications, and hospital length of stay.
RESULTS:
Among 184 patients with inhalation injuries, 69 (37.1%) had COPD. COPD patients were older (p<0.001) and more likely to be current smokers (p<0.001). TBSA was similar across groups (p=0.244). Intubation timing (p=0.926), COHb levels (p=0.248), hospital days (p=0.631), and complication rates (p=0.646) were similar between groups. However, COPD patients who died survived an average of 7.3 days longer than non-COPD patients after adjustment for age, COHb, and TBSA (SE=3.17, 95%CI [0.82, 13.8], p=0.029).
CONCLUSION:
COPD overall did not worsen outcomes for inhalation injury patients, suggesting that injury severity is a more critical determinant of clinical results. However, these patients exhibited slower functional decline in life-threatening cases, possibly due to the benefits of prescribed respiratory therapies.
